Improvement in Clinical Performance of Interns and Residents through Clinical Skills Assessment of the Korean Medical Licensing Examination / 한국의학교육

PURPOSE: To evaluate the clinical performance through the Korean Medical Licensing Examination clinical skills assessment (KMLE CSA) this survey was done. METHODS: A survey of 130 interns and residents (46 applicants and 84 non-applicants for the KMLE CSA) at a university hospital in Seoul was conducted in January and February 2012. The data were gathered using a structured and self-administered questionnaire. For the items that assessed the clinical performance of these subjects, we selected 15 items that are mostly frequently used by Delphi's technique, and difficult procedural skills based on the results of medical students' performance. We also used subcomponents of the clinical problems test of the KMLE CSA. RESULTS: The total score on the KMLE CSA improved by 1.33 points (a perfect score is 10), 1.49 points for procedural skills, and 0.84 points for clinical problems by multiple regression analysis. The variables that influenced clinical skills were sex (females had 0.86 more points than males), experience in military or public services (1.04 points higher than persons without experience), and type of school (graduates of medical school had 1.41 more points than graduates of professional graduate school). CONCLUSION: Implementation of the KMLE CSA improved the clinical performance of medical graduates.

Testing Unidimensionality and Goodness-of-fitness for the Application of Item Response Theory to the Korean Medical Licensing Examination / 한국의학교육

PURPOSE: In order to apply the item response theory to test results, the assumptions made about unidimensionality and item goodness-of-fitness should be tested before analysis. To know if the Korean Medical Licensing Examination results fulfill these assumptions, appropriate tests were done on these two features. METHODS: Three results(from three subjects) of the Korean Medical Licensing Examination, done in January 2004, were converted into 1, 0 data. The Holland and Rosenbaum Method(HRMH) and DETECT were used to test unidimensionality. The Winsteps was used to test goodness-of-fitness according to the Rasch model. RESULTS: Unidimensionality was rejected by HRMH but accepted by DETECT. With the Rasch model, 2 out of 550 items were inadequate. Each 137, 73 and 455 examinees out of 3,881 were inadequate in three subjects of 126, 400 and 24 items. CONCLUSION: The above results suggest that DETECT is desirable for testing unidimensionality of high-stakes tests with more than 100 items. According to the Rasch model, the Korean Medical Licensing Examination fulfills the goodness-of-fitness to be analyzed according to the item response theory.

Correlation Between the Academic Score, the Trial Examination Score, and the Korean Medical Licensing Examination Score / 한국의학교육

PURPOSE: We analyzed the correlation between the year-end student academic scores (grade score), the trial examination scores, and the Korean Medical Licensing Examination (KMLE) score by correlation analysis and multiple regression method. METHODS: Our subjects included 217 graduates between the years 2002 and 2003. Yearly, trial examinations, composed according to the principles of KMLE setting, are performed four times. For correlation and regression analysis, all scores were transformed to the standard score according to the standard score norm. RESULTS: In the regression analysis among each grade scores, the lower grade score always affected the higher grade score. Also all academic grade scores correlated significantly with the trial examination scores and KMLE score in bivariate correlation analysis (P< 0.05). But only grade score during the senior years (5th and 6th) affected the trial examination and KMLE score in multiple regression. According to the multiple regressions by each grade score and trial examination score, the 6th grade score and trial exanimation score except the 1st trial examination score have a significant effect on the KMLE score. And we can also establish the regression formula such as [KMLE score]=11.377+0.752*[mean of trail examination] with significant high power of explanation (R (2) =0.709, P< 0.001). CONCLUSION: Our results show that previous scores always affect the latter scores; and the last score in time sequence is a result of the accumulation of previous education and learning. From this point of view, the trial examination is a useful tool for not only the final assessment of medical achievements but also for preparing for the KMLE.

The Correlation of Grade Point Average of Medical School and the Score of Korean Medical Licensing Examination / 한국의학교육

PURPOSE: This study analyzed the correlation between grade point average (GPA) of medical school and the score of Korean Medical Licensing Examination (KMLE). METHODS: This study based on the results of 67th KMLE applicants who graduated from a college of medicine in 2003. We also gathered data of these applicants from the college of medicine: gender, age, type of entrance, GPA of basic medicine, clinical medicine, clinical clerkships and final test scores. We analyzed whether there was discrimination between achievement of KMLE passed and that of KMLE failed, which of variables affected the results of KMLE. RESULTS: 173 applicants passed KMLE among 189. There were significant correlations between basic medicine, clinical medicine, final test score and the score of KMLE (respective p-value; < 0.0001). There were also significant differences of GPA between KMLE passed applicants and failed. Final test scores were the most correlated with those of KMLE. If the GPA of 2nd grade was below 2.5 and the GPA of 3rd year grade was below 2.3, they was a high-risk group for failing KMLE (sensitivity 100%, specificity 90%). CONCLUSION: There were significant correlations between the GPA of medical school and the score of KMLE, and significant differences between KMLE passed applicants and failed. A high-risk group of failing KMLE was the students that the GPA of 2nd grade was below 2.5 and the GPA of 3rd grade was below 2.3.